NEW CANAAN, CT, August 19, 2004—An article published today in The New England Journal of Medicine calls attention to the enormous impact of parasitic hookworm infection on the developing world poor. The authors of “Current Concepts: Hookworm Infection” have studied the parasite over many years and describe the disturbing effects of mild infection as well as the disease state that results from heavy hookworm infection.

According to Peter J. Hotez, MD, MPH, the article’s lead author, hookworm is one of the most common infections in humans with an estimated 740 million cases in areas of rural poverty in the tropics and subtropics. In China alone, approximately 190 million people are infected. Measured against other diseases, hookworm outranks African trypanosomiasis, dengue, Chagas disease, schistosomiasis, and leprosy in its impact on individuals and society.

Hookworm infection plagues vast areas of Asia, Africa, and Latin America and was once prevalent in the United States. Here it was surmounted by sanitation improvements that accompanied 20th century economic development. Ultimately, poverty reduction and economic development has done the most to eliminate hookworm in industrialized nations, but for those living in poor endemic areas around the world, such socioeconomic reforms are a distant prospect.

The term “hookworm disease” refers to the iron deficiency anemia that results from moderate and heavy infections. Worms fasten onto the inner layers of the small intestine and cause blood loss. According to the authors, each hookworm can grow to one centimeter and cause up to 0.2 cc of blood loss per day, and chronic intestinal blood loss results from heavy infections. Because women and young children have the lowest iron stores, they are the ones most vulnerable to chronic hook-worm blood loss. Hookworm infection adversely effects childhood memory, reasoning ability and reading comprehension.

The current method of hookworm removal is a single dose treatment. However, in highly endemic areas, hookworm infection often reoccurs within just a few months. This, compounded by growing concerns about emerging drug resistance has prompted efforts to identify new tools for hookworm control, including a vaccine.

The Human Hookworm Vaccine Initiative of the Sabin Vaccine Institute and the Bill & Melinda Gates Foundation is being conducted at The George Washington University Medical Center. For more information, visit www.sabin.org. Dr. Hotez is lead scientist for the Hookworm Vaccine Initiative. He is professor and chair of microbiology and tropical medicine, The George Wash-ington University and a senior fellow and Chair of the Sabin Vaccine Institute's Scientific Advi-sory Council. Dr. Hotez can be contacted at his lab at 202-994-3532 or mtmpjh@gwumc.edu.